Monday, June 30, 2008

Diabetic for a Day

Or two. DEX makes us temporarily diabetic by messing with the glucose transport system, which decreases the body's normal ability to move glucose out of the blood and into muscles and other organs.

I have a blood glucose monitor and did a simple study of my own blood glucose, taking a reading every half hour or so all day long, on four different sore-fingered days. Here is the bottom line result, where Day 1 is the next day after taking the DEX the previous evening. The "glucose" value is an average for the whole day, expressed in mg/dL:

Day  Dose mg  Glucose   Comment
1 40 144   Highest was 193
2 40 101
5 40 88   DEX effect must be gone
1 20 116

Click to enlarge, BACK to return right here More information about this little personal "study" is detailed in earlier blog posts HERE and HERE. Graphics included. The graph here shows Days 1, 2, & 5 on 40 mg DEX.

I am NO expert in diabetes, but when Dr. L at Mayo saw the graphics and numbers for Day 1, she reduced my DEX dosage from 40 mg to 20 mg. The glucose spike of 193 mg/dL seemed to be a particularly important factor. Fasting glucose for a non-diabetic should be in the range of 80 to 120, and diabetics are urged to keep their glucose, fasting or not, below 180.

Many diabetics will need insulin shots along with a careful diet, but those of us who are not normally diabetic already have the insulin, except that its effect is inhibited by the DEX. Therefore we need to manage our temporary DEX-induced "diabetes" at least partly through diet. When I asked Dr. L about this, she commented that several of her patients are eating a low-carb diet on DEX day.

Here is a set of dietary principles that I have recently been following, with the help of Sunshine and Sweet Pea (they're the cooks!), on DEX day 1 and, to some extent, on Day 2:
  • Most important: Keep the amount of food modest, because all food raises blood sugar. I do this with Weight Watchers "journaling," but calorie counting would work too;
  • Reduce carbohydrates in favor of protein, and good fats such as nut oils, olive oil, and fish oils;
  • Prefer carbohydrates with a low glycemic index, to reduce the glucose spike;
  • Eat some of the protein and fat first at each meal, because this slows the entire digestive process and thereby moderates the glucose spike;
  • Good food: Chicken, fish, vegetables, nuts, eggs, certain fruits and berries, legumes, whole-grain foods; and
  • Bad food: Sugar (except fructose), soda, potato, candy, white bread or any relative, (the list goes on).
One caution: People whose kidneys are already at risk should be careful about increasing protein, and every myelomiac should take plenty of fluid to help the kidneys. As always CONSULT YOUR DOCTOR! But don't settle for "oh, don't worry about it." This is real, and somewhat outside the experience of many oncologists. Know what you are talking about, be your own advocate, and press a little. If you're interested, a blood glucose monitor costs between $30 and $100 with supplies.

You might notice that the foods that we eat on the DEX diet are foods that are really good for us anyway, and delicious. Those that are bad are ones that we never eat, ever. We just tilt the balance of protein, fat, and carbohydrates. So except for the protein issue for those with kidney disease, there is no downside to eating like a diabetic for a day or two. The food can be wonderful!

I wholeheartedly invite your comments, pro or con, and I especially hope that you will straighten me out if I have made any errors, or share with us if you have something to add.

Examples of DEX day meals that I have recently eaten. Oh, the suffering that we put ourselves through :-)
DEX lunch
Today's DEX lunch: Organic chicken breast, Jim's broccoli, dill cheese, organic strawberries. Weight Watchers points = 6.

DEX Salad
Today's DEX salad: Organic romaine, cucumber, avocado, organic cashews, organic strawberries, pecans, organic red wine vinegar. Weight Watchers points = 6.

DEX Dinner
Yesterday's DEX dinner: Wild-caught Alaskan sockeye salmon, organic lime, Jim's organic beet greens, spinach, and onions, with a few organic raisins, plus orange and mango. Weight Watchers points = 8.

8 comments:

  1. Hi Don,

    For some, it's a good idea to see an endocrinologist. Mine said they would not treat unless my morning glucose was over 200, which it never reached, thank goodness.

    Exercise also helps lower blood sugar. I noticed some dramatic drops just after a 1/2 mile walk. The muscle takes up some of the glucose -- like magic!

    I was on dex for so many years that I half expected to come out of it diabetic, but luckily did not. I did have bone loss and a cataract started. Steroids are nasty. Lots of things to watch out for.

    Beth

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  3. I'm not sure waht to think about the above comment by "eagle." In my opinion it's mostly bunk, and Eagle is careful not to give any identification.

    I think it's a "spam comment" by VitaCost, one of the online supplement suppliers, because the EXACT same comment was left on another of my blogs.

    I'm leaving it here, but remember that Eagle has substantiated nothing of what he/she says.

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  5. Hello Nathaniel,

    I appreciate your comment and that you have checked back. After I posted my comment I did notice that you had what seemed to be a valid email address in your Blogger profile, which took away some of my skepticism.

    I think that oncologists read Blood and the other oncological magazines, and that if they thought that HHv-8 (Kaposi's Virus) was highly involved in myeloma, that would be a primary avenue for treatment. Further, since HHV-8 is communicable, spouses and others would have a higher incidence of myeloma than the general public. Still further, in the parts of the world where HHV-8 is endemic, myeloma would be more prevalent than in the rest of the world, but apparently it is not. Here is a link to an article suggesting that earlier studies showing a close correlation between HHV-8 and myeloma might be wrong: http://jmd.amjpathol.org/cgi/content/abstract/3/1/32. So I'm unconvinced. Still, though, I will ask Dr Lacy about this when I see her in a little over a week. Few people know more than she does about such things.

    Indeed I do believe in adding potassium to calcium in the right proportions to strengthen bones. Further, and possibly more important, is a sufficiency of Vitamins D3 and K2, as you mention. These two work together to scavenge calcium from where it is not needed (such as inside the arteries and vessels) and deposit it in the bones where it belongs, possibly as efficiently as bisphosphonates and without the drawbacks. Here's one reference of many: http://findarticles.com/p/articles/mi_m0FDN/is_1_10/ai_n13557316/pg_6">http://findarticles.com/p/articles/mi_m0FDN/is_1_10/ai_n13557316/pg_6.

    I will ask my naturopathic doctor about extra folic acid, methyl B-12, coenzyme vitamin B6, spirulina, chlorella, and Jobelyn. I am personally taking a good "B 100" supplement now, but most of those elements are absent. I don't take thalidomide, but I do take a close relative, and my red count is naturally on the low side anyway so I should try to improve it. I also believe in EGCG, and I take it. And we do use cinnamon in food, for blood sugar, especially on DEX day.

    Indeed I have read the Michael Gearin-Tosh story. To be honest, the Gerson diet and other protocols that he followed were too much for me to think about, too large a lifestyle change at the time I read it. Perhaps now ...

    Anyway I do know several people who have survived more than 10 years - peope who still come to support group meetings and appear perfectly healthy. I think the longest-lived survivor I know is 17 years. These folks have all had conventional treatment, of course, including stem cell transplants. But it does show that the Gearin-Tosh methodology is not the only way. Nevertheless, I will definitely look into B-12, methyl and not cyano.

    Thank you again,

    Don

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  7. Praying for you. I think all will be ok. I know how important it is to exercise properly and to eat right. I have trained quite a few people who have different related diseases. I truly hope everything works out.

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  8. 9/11 Nukes - Radiation-induced cancers -

    http://covertoperations.blogspot.com/2009/08/new-study-of-911-responders-with-immune.html

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